Gordon Brown: the case for presumed consent
Prime Minister Gordon Brown, writing in a national newspaper, recently set out his case in support of an overhaul of the way in which organ donations are managed. Below are highlights from his comments on the issue of presumed consent.
We know that transplant surgery is one of the great advances of medical science, and has saved the lives of thousands. Yet the organ donation on which it depends remains a difficult and sensitive issue on which feelings can be strong. Many of us will have friends and family members who have benefited from transplant surgery, or – tragically – who have endured the agonising wait for a life-saving organ that did not become available in time.
Avoidable tragedy
That is an avoidable human tragedy we can and must address. There are currently more than 8,000 people in the UK awaiting organ donation, but only 3,000 transplants are carried out each year. Sadly, that means that more than 1,000 people die each year waiting for transplants. So we need to do more to ensure that organs are available to those who need them. This week, the Organ Donation Taskforce will report on how we can improve the management of transplant services and organ donations, and will set out a series of recommendations.
However, we may need to do more to encourage more of us to donate. In Britain we have 14.9 million people on the organ donor register – which is around 24 per cent of the population. In terms of actual donors (not just people willing to give, but those whose organs are actually used) we have a rate of about 13 donors per million in our population. This compares with about 22 per million in France, 25 per million in America and around 35 per million in Spain – the best in the world.
Survey findings
That is why I want to start a debate in this country about whether we should take steps to move towards a new system designed to enable far more of us to benefit from transplant surgery – one that better reflects survey findings that around 90 per cent of us are in favour of organ donation.
Sadly, only around a quarter of us have made specific advance arrangements by registering as potential organ donors. So about two-thirds of us – positive, but not registered as organ donors – are unable to help save the lives of others by organ donation when the circumstances arise.
Right and proper
A different consent system, more like the one used in Spain, could serve to increase donation levels significantly. Of course, any "opt-out" system would – in cases where the potential donor is not on the register – leave the final decision with the family: that is only right and proper.
But a system of this kind seems to have the potential to close the aching gap between the potential benefits of transplant surgery and the limits imposed by our current system of consent.
A serious debate – involving the public most of all, but also bringing in professional views and those of religious leaders – is long overdue. To facilitate it, Alan Johnson and I have asked the Organ Donation Taskforce to begin consulting on the question of a move to a different consent system.
It is a sensitive issue, and one on which many different points of view need to be heard. I want to start a genuine debate, and I recognise that there will be legitimate concerns that need to be heard. Any system that moved towards a new kind of consent needs careful safeguards, and we should not move in advance of a real and thoughtful public debate involving faith communities, patients and families.
Prime Minister Gordon Brown, whose views appeared in full in the Sunday Telegraph.
Head-to-head: the case against presumed consent
In response to the prime minister, watchdog Patient Concern argues that presumed consent equates to "no consent at all" and is a violation of patients' rights. Read its case against the policy here.
Real lives: the human face of organ donation
The parents of a young recipient tell of their gratitude towards his donor and the way in which the transplant has transformed their lives; and the family of a donor recount the difficult but ultimately rewarding decision to donate their loved one’s organs. Read their stories here.
